Organization
INDIANA RETINA CENTER LLC
Active
Other names
Indiana Retina Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES DAEOK KIM MD (PRESIDENT)
(260) 305-2822
Entity
Organization
Contact information
Practice address
7802 W JEFFERSON BLVD STE A, FORT WAYNE, IN 46804-4138
(260) 305-2822
(260) 305-2829
Mailing address
7802 W JEFFERSON BLVD STE A, FORT WAYNE, IN 46804-4138
(260) 305-2822
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Enumeration date
04/11/2022
Last updated
03/03/2026
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